Science Current Events | Science News | Brightsurf.com
 
Email a Friend Send to a friend
Printer Friendly Print New results help predict treatment response in colorectal cancer

New results help predict treatment response in colorectal cancer

September 17, 2008

Genetic testing can identify a group of patients with advanced colorectal cancer who are likely to survive on average twice as long if treated with the drug cetuximab, late breaking results show.

At the 33rd Congress of the European Society for Medical Oncology (ESMO) in Stockholm, Dr. Christos Karapetis from Flinders University in Australia reports on a genetic analysis of 394 patients who took part in a phase III study comparing the monoclonal antibody cetuximab with best supportive care.




The latest analysis compared the effect of mutations in the K-Ras gene on overall survival and progression-free survival. The gene encodes a protein that is a key component of cellular signalling pathways, conveying extracellular growth signals from the cell surface to the nucleus. When growth factors bind to cell surface receptors, including epidermal growth factor receptor (EGFR), K-Ras is temporarily activated, facilitating regulated cell growth and proliferation.

The K-Ras gene is mutated in up to 35% of colorectal cancers. These mutations keep K-Ras stuck in its active form, switching on signalling without the requirement for EGFR stimulation.

Dr. Karapetis and colleagues found that patients with mutated forms of K-Ras had a median overall survival of 4.6 months when treated with cetuximab, and 4.5 moths with supportive care. In contrast, among those with wild-type forms, overall survival jumped to 9.5 months when treated with cetuximab, compared to 4.8 months with best supportive care.

The results show that determining K-Ras mutation status should be considered a new standard of care for selecting patients for targeted therapies against EGFR, the authors say.

Also at the congress, Professor Eric Van Cutsem from University Hospital Gasthuisberg, Leuven in Belgium will present data on the impact of K-Ras mutations from the Crystal study, in which patients were randomized to either the chemotherapy combination "FOLFIRI" or FOLFIRI plus cetuximab, in first line metastatic colorectal cancer.

Professor Van Cutsem recently reported that the combination of cetuximab and FOLFIRI significantly improves progression free survival and response rate in patients with a K-Ras wild type. In Stockholm he will present new data on survival in the Crystal trial.

"Overall survival in all patients included in the trial was identical in both treatment arms. There was however a strong trend towards a longer survival in patients with a K-Ras wild type tumor treated with cetuximab/FOLFIRI," he said. The median survival was 24.9 months for patients who received the cetuximab combination, versus 21.0 months (HR: 0.84). The overall survival results in patients with K-Ras mutant tumors did not differ in the two study arms.

In another study, Dr. Miriam Koopman from the University Nijmegen Medical Centre St. Radboud in The Netherlands, reports that the number of tumor cells found circulating in the blood of patients with advanced colorectal cancer is another valuable predictor of survival.

Her group studied 467 patients who were being treated within a prospective clinical trial (CAIRO2 of the Dutch Colorectal Cancer Group) with chemotherapy plus bevacizumab, with or without the addition of cetuximab. In each patient they measured levels of circulating tumor cells before treatment, and at different stages during treatment.

"Circulating tumor cell (CTC) level might be an indicator of the aggressiveness of disease," Dr. Koopman explained. "Thus, a high CTC level before initiating therapy in metastatic colorectal cancer patients is an inferior prognostic factor in our study."

The results show that the median progression-free survival time for patients with less than three CTC in every 7.5mL of blood was 10.5 months, compared to 8.2 months for those with three or more. Furthermore the median overall survival time for patients with less than three CTC in every 7.5mL of blood was 22.2 months, compared to 13.7 months for those with three or more.

"In our study CTC in metastatic colorectal cancer patients proves to be an early prognostic marker," Dr. Koopman said. "Prospective trials are needed to investigate whether a change in therapy based on CTC is beneficial."

European Society for Medical Oncology



Related Colorectal Cancer Current Events and Colorectal Cancer News Articles Colorectal Cancer Current Events and Colorectal Cancer News RSS Colorectal Cancer Current Events and Colorectal Cancer News RSS
'Cross-talk' mechanism contributes to colorectal cancer
Researchers at the University of Wisconsin-Madison School of Medicine and Public Health have identified a molecular mechanism that allows two powerful signaling pathways to interact and begin a process leading to colorectal tumors.

African-Americans with colorectal cancer have poorer outcomes, lower survival rates
New research published in the November issue of the Journal of the American College of Surgeons shows that African-American patients with colorectal cancer are more likely to be diagnosed with advanced disease and are less likely to undergo surgical procedures compared with Caucasians, suggesting that improvements in screening and rates of operation may reduce differences in colorectal cancer outcomes for African-Americans.

Colon cancer screening more effective earlier in day, UCLA study finds
The effectiveness of a screening colonoscopy may depend on the time of day it is performed. According to a new UCLA study, early-morning colonoscopies yielded more polyps per patient than later screenings, and fewer polyps were found hour by hour as the day progressed.

1 disease, not 1 demographic
The Asian continent has nearly four billion people living in 47 different countries, and each of these groups has their own unique set of health issues. But when they come to the United States, they're often lumped into one large demographic: "Asian/Pacific Islander."

Study shows unsedated colonoscopy for colorectal cancer screening well accepted by patients
Researchers from Taiwan report in a new study that unsedated colonoscopy for primary colorectal cancer screening is well accepted in a majority of patients.

M. D. Anderson redefines screening guidelines for breast, cervical and colorectal cancers
Drawing on years of experience in cancer research and patient care, The University of Texas M. D. Anderson Cancer Center released today the most comprehensive, risk-based screening guidelines publicly available to date for breast, cervical and colorectal cancers.

The bowels of infection
Current research suggests that latent cytomegalovirus (CMV) infection may exacerbate inflammatory bowel disease (IBD). The related report by Onyeagocha et al, "Latent cytomegalovirus infection exacerbates experimental colitis," appears in the November 2009 issue of The American Journal of Pathology.

How to Lower Costs, Waiting Times for Colonoscopies
Colorectal cancer is a leading cause of cancer-related deaths in the United States, leading to over 50,000 fatalities every year.

Excess body weight causes over 124,000 new cancers a year in Europe
At least 124,000 new cancers in 2008 in Europe may have been caused by excess body weight, according to estimates from a new modelling study.

Adding cetuximab to chemotherapy reduces advanced lung cancer death risk by 13 percent
Patients with advanced non-small cell lung cancer who are given cetuximab (Erbitux) in addition to chemotherapy are 13% less likely to die than those who receive chemotherapy alone, regardless of which chemotherapy drug cocktail is used, new research finds. They also experience slower disease progression and an increased chance of tumour shrinkage.
More Colorectal Cancer Current Events and Colorectal Cancer News Articles
American Cancer Society's Complete Guide to Colorectal Cancer

American Cancer Society's Complete Guide to Colorectal Cancer
by American Cancer Society (Author)

Don't die of embarrassment--get informed about colorectal cancer

Although colorectal cancer is the third most common cancer found in men and women, you may be unaware of your risk and don't know what you can do to prevent this serious disease. You may be too embarrassed to ask your doctor about changes in your bowel habits or get screened for colorectal cancer. American Cancer Society's Complete Guide to Colorectal Cancer provides sound information and support if you are concerned about or diagnosed with colorectal cancer.

Written by experts in oncology, nursing, research, and colorectal cancer care, the up-to-date, evidence-based text explores every aspect of colorectal cancer, from physical to emotional aspects of the disease, including:

What colorectal...

Be a Survivor: Colorectal Cancer Treatment Guide

Be a Survivor: Colorectal Cancer Treatment Guide
by Vladimir Lange (Author)

Dr. Lange’s comprehensive overview of cancer and treatment options offers detailed information using simple, concise language and a wide variety of color photos and drawings. Colorectal cancer patients need to know more about their disease, yet there is an overload of information. Be a Survivor gives the patient the specific, reliable and necessary information to make good decisions about their cancer and treatment options. Annually, 150,000 Americans are told they have colorectal cancer, making it one of the top three most common cancers in the United States. Diagnosed early, colorectal cancer is treatable, often curable, and vey preventable. This resource covers all aspects of colorectal cancer—from diagnosis to recovery, including a chapter for the patient's spouse.

  Progress in Colorectal Cancer
by Mediscript



First Check Home ColoCheck Home Test, Colorectal Disease, 1 Test (Pack of 2)

First Check Home ColoCheck Home Test, Colorectal Disease, 1 Test (Pack of 2)
by First Check

A First Check at 50 product. No specimen handling. No diet restrictions. FDA cleared. Fast. Accurate. Simple. A home test for the early warning signs of Colorectal Disease. Results in minutes. Early detection is key. First Check ColoCheck provides informa

New Tests, Treatments: Better Outcome for Colorectal Cancer

New Tests, Treatments: Better Outcome for Colorectal Cancer

Colorectal cancer is the third most common cancer and the second leading cause of cancer mortality in the U.S. Advances in imaging, genetics, molecular diagnostics, surgical techniques and chemotherapy are now making significant gains in our ability to prevent, diagnose, and treat this serious disease. Dr. Fisher reviews some of these recent successes and shares a vision of future care based on current research.

  Screening for Colorectal Cancer: An Easy Step to Save Your Life (Three Real Patient Stories)
Also With: American Digestive Health Foundation (Producer), Chuck Peet (Host)



Beating Colorectal Cancer Together Long Sleeve T-shirt Large White

Beating Colorectal Cancer Together Long Sleeve T-shirt Large White
by Shop Zeus



Colorectal Cancer Awareness Ribbon Mouse Pad

Colorectal Cancer Awareness Ribbon Mouse Pad
by MyHeritageWear.com

The Colorectal Cancer Ribbon proudly displayed on a mouse pad. There is no better way to achieve awareness for the meaning of the Colorectal Cancer Ribbon than to display it on your mouse pad for everyone to see. The mouse pad measures at 9.25 x 7.75, it is machine washable, and the colors will not fade or run. Start gaining awareness today by presenting your Colorectal Cancer Ribbon mouse pad at work or at home. It is certain to keep your mouse rolling in style all while gaining support and awareness!

Understanding Colorectal Cancer Anatomical Chart (Laminated)

Understanding Colorectal Cancer Anatomical Chart (Laminated)
by Anatomical Chart Company

Understanding Colorectal Cancer Anatomical Chart defines colorectal cancer and shows colorectal anatomy with the following pathologies: * Adenocarcinoma of colon * Circumferential carcinoma of the transverse colon * Colonic polyps * Adenocarcinoma of jejunum * Adenocarcinoma of the rectosigmoid region The chart describes risk factors, signs and symptoms, screening and diagnostic tests, and treatment options, and illustrates and explains the stages of cancer.

Beating Colorectal Cancer Together Keychain

Beating Colorectal Cancer Together Keychain
by Design a Product LLC

Text on keychain: Beating Colorectal Cancer Together
* Durable acrylic key chain is crystal-clear and double-sided so the artwork or message is seen twice.
* Sturdy metal ring holds your keys securely.
* Full color printed images or messages are included.
* If you have new ideas or need help selecting text for your custom keychains please contact us.
* Size: 2 1/8" x 3 1/2" (Approx. business card)

© 2009 BrightSurf.com